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Medical Decision Making
Overview
Why is it important for long-term care communities to be attentive to an LGBTQ+ resident’s durable power of attorney for medical and financial decision-making?
LGBTQ+ people often rely on caregivers who are not legally recognized, such as unmarried partners and families of choice. Because of this, these caregivers can be excluded from decision-making on a loved one’s medical care and end-of-life plans, unless there are specific legal arrangements in place.
Without legal protections, such as durable power of attorney, most states will prioritize opposite-sex spouses and blood relatives for medical and long-term care decisions, including end-of-life care, regardless of the closeness of their relationship with the individual in question. These decisions may supersede closer, non-legal relationships. The problem is pervasive and some experts estimate that up to two-thirds of LGBTQ+ older adults do not have the necessary legal paperwork completed, leaving them unprepared and without needed legal protections in place.
It’s critically important for long-term care communities to cover this topic with residents, encouraging them to secure the necessary protections and then keeping a copy of important documents on file to be referenced in a time of need.
LEI Survey Questions
One of the best ways to ensure that all LGBTQ+ residents receive information about their right to designate a person of their choice as medical and financial decision-maker is to share this information broadly and with all residents. Many LGBTQ+ residents may choose not to share information about their sexual orientation and gender identity/expression, so using a universal communications approach reaches all residents.
Using this approach provides the added benefit of helping to protect heterosexual and cisgender individuals who may likewise prefer to designate someone other than a spouse or blood relative as their medical and financial decision-maker.
To receive credit in the LEI, a community must:
-Describe how the organization informs residents of their rights and upload supporting documentation
-Include language that states the resident can designate a person of their choosing and/or include LGBTQ+ specific information
Example:
NYC Health + Hospital long-term care community provides the following document that utilizes gender neutral/inclusive language
To receive credit in the LEI, a community must:
-Provide a written description of how the training is LGBTQ+ inclusive and upload supporting documentation (slides from training, etc.).